WO2006024801A2 - Implant comprising one or more electrodes and corresponding insertion instrument - Google Patents

Implant comprising one or more electrodes and corresponding insertion instrument Download PDF

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Publication number
WO2006024801A2
WO2006024801A2 PCT/FR2005/002143 FR2005002143W WO2006024801A2 WO 2006024801 A2 WO2006024801 A2 WO 2006024801A2 FR 2005002143 W FR2005002143 W FR 2005002143W WO 2006024801 A2 WO2006024801 A2 WO 2006024801A2
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WO
WIPO (PCT)
Prior art keywords
implant
instrument
electrodes
electrode
insulator
Prior art date
Application number
PCT/FR2005/002143
Other languages
French (fr)
Other versions
WO2006024801A3 (en
Inventor
Maurice Bourlion
Original Assignee
Spinevision
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US11/660,418 priority Critical patent/US8486119B2/en
Priority to EP05798589.7A priority patent/EP1781198B1/en
Priority to BRPI0515208A priority patent/BRPI0515208B8/en
Priority to ES05798589.7T priority patent/ES2534992T3/en
Priority to CA2578346A priority patent/CA2578346C/en
Priority to CN2005800364469A priority patent/CN101048111B/en
Application filed by Spinevision filed Critical Spinevision
Priority to AU2005279023A priority patent/AU2005279023B2/en
Priority to JP2007528926A priority patent/JP2008510549A/en
Publication of WO2006024801A2 publication Critical patent/WO2006024801A2/en
Publication of WO2006024801A3 publication Critical patent/WO2006024801A3/en
Priority to IL181534A priority patent/IL181534A/en
Priority to KR1020077006162A priority patent/KR101473374B1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated

Definitions

  • the present invention relates to the field of general orthopedics, and more particularly to the placement of implants, in particular screw-type implants, pins, etc., for the implementation of devices allowing, for example, the correction and stabilization of spine or fracture reduction.
  • Such implants are intended to be positioned in the bone structure.
  • a poor positioning of the implant may not give a satisfactory therapeutic result. It can also provoke in the patient pains, paralysis, haemorrhages, etc., often requiring a new surgical intervention, even in some cases causing irreparable damage.
  • said tracking device object of the application comprises at least one electrostimulator capable of performing neuromuscular stimulation and can be connected to at least two electrodes of which at least one is located at a distal end of the drill instrument at least one impedance meter connected to at least two electrodes, at least one of which is located at a distal end of the drilling instrument, and at least one signaling device capable of producing a signal in the event of detection, by 1 ' impedance meter of an impedance variation.
  • the purpose of the present invention is to provide equipment for monitoring and guiding an implant during its implementation in a bone structure, the latter being drilled either directly by the implant during its installation, or during a preliminary operation.
  • the invention relates, in its most general sense, to an implant intended to be placed in an anatomical structure, in particular a bone structure.
  • said implant comprises at least two electrodes separated from one another by an insulator, said electrodes flush with the surface of said implant so as to allow tracking and guiding said implant during its establishment in the anatomical structure.
  • said electrodes are arranged such that: i) one of the electrodes is at least partially flush with the peripheral surface of said implant, ii) the other electrode is punctually flush with the peripheral surface of said implant.
  • said electrodes are arranged in such a way that: i) one of the electrodes forms at least part of the peripheral surface of said implant, ii) the other electrode, internal to said implant, is punctually flush with the distal surface of said implant.
  • the outer electrode is substantially tubular in shape.
  • said internal electrode is advantageously of substantially tubular shape.
  • said electrodes are coaxial or eccentric.
  • the (or) electrode (s) is (are) removable (s).
  • said insulator is also removable. In this case, its withdrawal will be performed commonly with said internal electrode or after removal of the latter.
  • the present invention also relates to the implant not provided with the removable part described above, namely the internal electrode, and possibly the insulator.
  • the implant crossed by a channel, comprises at at least one electrode flush with at least a portion of the peripheral surface of said implant, constituting all or part of the side wall of said implant.
  • said implant is constituted by a tubular electrode.
  • said implant comprises an insulator of tubular form.
  • said channel passes longitudinally through said implant.
  • the channel is a central channel.
  • the present invention also relates to a placement instrument for placing the implants previously described in an anatomical structure, in particular an anatomical bone structure.
  • said instrument is connected to a voltage source supplying at least two electrodes and a means for measuring the impedance between said electrodes.
  • said instrument has an inner longitudinal portion.
  • This longitudinal portion is intended to be housed in the canal of the implant.
  • said longitudinal portion will consist of an electrode or an electrode surrounded by an insulator.
  • the longitudinal portion of said instrument is removable.
  • said instrument is adapted to engage with an implant itself comprising an inner electrode, which is separated from the outer electrode by an insulator.
  • said instrument comprises means allowing electrical contact with the (or) electrode (s) when said implant is engaged by said instrument.
  • the electrical contact may be made internally and / or externally. So, for a internal contact, said laying instrument will comprise electrical contact elements positioned to be in contact with the internal electrode of the implant; for an external contact, said instrument will comprise electrical contact elements positioned to be in contact with the peripheral electrode of said implant.
  • said instrument comprises a cavity for partially receiving said implant, as well as means for centering said implant housed in said instrument.
  • said laying instrument comprises means for mechanical drive of the implant.
  • the implant and the instrument thus configured, it is then possible to follow the progress of the implant during its placement in the bone structure by the analysis of an electrical signal established by means of said electrodes.
  • the impedance decreases abruptly.
  • the patrician rectifies the trajectory given to the implant to reposition it in the bone structure. This is done until the final placement of said implant.
  • FIG. an implant according to one embodiment of the invention
  • Figure 2 illustrates a sectional view of the implant of Figure 1 after removal of the removable portion of said implant, and a sectional view of the removable portion removed from the implant
  • FIG. 3 illustrates a schematic view of a placement instrument in engagement with the implant of FIG. 1
  • FIG. 4 illustrates a sectional view of an implant according to a second embodiment of the invention, said implant being engaged with a laying instrument.
  • Figure 1 illustrates a sectional view of an implant
  • the implant (1) of the pedicle screw type, has a cylindrical threaded body (2) having a tip-shaped distal end (13), the other end being provided with a head (3).
  • the present invention is not limited to this implant configuration, it has been chosen in this case for its simplicity and thus facilitate the description of the invention.
  • the body (2) of said implant (1) comprises two conductive parts separated by an insulator (6). More particularly, each of the conductive parts is constituted by an electrode (4, 5): a first electrode (4) forming the side wall of said implant (1) ("external electrode") so that the external electrode (4) is flush with the lateral surface (17) and a portion of the distal surface (18) of the body (2) of said implant (1); a second electrode (5) constituting an inner part of said implant (“internal electrode”) and punctually flush with the distal surface (18) of the body
  • the inner electrode (5) in the form of a rod of circular section, passes longitudinally through said implant (1). It is surrounded by the insulator (6) itself surrounded by the outer electrode (4).
  • said electrodes (4, 5) are arranged so as to be coaxial.
  • the body (2) of said implant (1) may consist for example of two eccentric electrodes.
  • the inner electrode (5) and the insulator (6) extend through the head (3). said implant (1).
  • said implant (1) comprises a removable part (14).
  • said removable portion (14) is removed, generally once the implant (1) positioned in the bone structure, a channel is formed in said implant (1) along its longitudinal axis (see Figure 2).
  • the removable portion (14) comprises both the inner electrode (5) and the insulator (6).
  • the removable portion (14) of the implant (1) consists only of the internal electrode (5), the insulation (6) remaining in said implant ( 1) during removal of said removable portion (14).
  • implantable only the remaining materials in the patient's body to be 'imperatively called “implantable", the parts of the implant removed once it is disposed in the bone structure may only be made as biocompatible materials. Since biocompatible materials are less expensive than implantable materials, an implant comprising a removable part will thus have the advantage of presenting a cost of the
  • FIG. 3 illustrates a simplified view of the electrical contact between an instrument (11) for placing an implant in a bone structure, and the implant (1) previously described.
  • an ineffective contact has been shown between said implant (1) and said instrument (11).
  • the electrical contact between the laying instrument (11) and the implant (1) is achieved by means of connecting lugs (12, 19) constituting said laying instrument (11): a connecting lug (19) internal contacting the internal electrode (5) of said implant (1), and at least one external connecting lug (12) coming into contact with the external electrode (4) of said implant (1).
  • the connecting lugs (12, 19) of the laying instrument (11) are connected to a means of measuring the impedance between said electrodes (4, 5) (impedance meter 20).
  • Said impedance meter (20) may advantageously be connected to an alert device (not shown) that can emit a visual, audible and / or tactile warning signal during a variation of the measured impedance or in case of crossing of an impedance threshold.
  • said impedance meter (20) may advantageously be connected to a display device (not shown) for displaying the variations of the impedance measured between said electrodes (4, 5) by the impedance meter (20).
  • a display device for displaying the variations of the impedance measured between said electrodes (4, 5) by the impedance meter (20).
  • This may be for example a display screen for tracking, in the form of curves, the variation of impedance as implant penetration (1) into the bone structure.
  • Figure 4 illustrates a sectional view of an implant (10) according to another embodiment of the invention and a delivery instrument (11) for placing said implant (10) in the bone structure.
  • said implant (10) consists of a conductive threaded body (2) having a pointed distal end (13).
  • the body (2) of said implant (10), tubular in shape, is provided with a channel (7) passing from one end to another body (2) of said implant (1).
  • the body (2) of said implant (10) is constituted by an electrode (4).
  • Said laying instrument (11) intended to engage with said implant (10) consists of a hollow body (8) provided with a central longitudinal portion (9), which is intended to be housed in the channel (7). ) of said implant (10) when it is engaged with said instrument (11).
  • said central longitudinal portion (9) consists of an electrode (15) surrounded by an insulator (16). It is of course obvious that the longitudinal portion (9) may consist only of the electrode (15), the implant intended to engage with said laying instrument (11) itself comprising an insulator.
  • said implant (10) is attached to the end of said instrument (11), and the longitudinal portion (9) of said instrument (11) housed in the channel (7) of said implant (10).
  • connection tabs (12) coming into contact with the electrode (4) constituting said implant (10).
  • said laying instrument (11) may comprise manual mechanical drive means or electric motor type, allowing for example to drive the implant in rotation, thrust, or other .

Abstract

The invention relates to an implant (1) for placing in an anatomical structure, in particular, in a bony structure, characterised in comprising at least two conducting electrodes (4, 5) separated by an insulator (6) flush with the surface of said implant.

Description

IMPLANT COMPRENANT UNE OU PLUSIEURS ÉLECTRODES ET INSTRUMENT DE POSE ASSOCIÉ IMPLANT COMPRISING ONE OR MORE ELECTRODES AND ASSOCIATED INSTALLATION INSTRUMENT
La présente invention concerne le domaine de l'orthopédie générale, et plus particulièrement la pose d'implants, notamment d'implants du type vis, broches, etc., pour la mise en place de dispositifs permettant par exemple la correction et la stabilisation de la colonne vertébrale ou la réduction de fractures.The present invention relates to the field of general orthopedics, and more particularly to the placement of implants, in particular screw-type implants, pins, etc., for the implementation of devices allowing, for example, the correction and stabilization of spine or fracture reduction.
De tels implants sont destinés à être positionnés dans la structure osseuse.Such implants are intended to be positioned in the bone structure.
Une des principales difficultés dans la pose de ces implants est, pour le praticien, de parvenir à positionner correctement ces implants.One of the main difficulties in the placement of these implants is for the practitioner to successfully position these implants.
Or, un mauvais positionnement de l'implant peut ne pas donner un résultat thérapeutique satisfaisant. Il peut également provoguer chez le patient des douleurs, paralysies, hémorragies, etc., nécessitant souvent une nouvelle intervention chirurgicale, voire dans certains cas causant des dommages irréparables.However, a poor positioning of the implant may not give a satisfactory therapeutic result. It can also provoke in the patient pains, paralysis, haemorrhages, etc., often requiring a new surgical intervention, even in some cases causing irreparable damage.
Il s'avère donc nécessaire pour le praticien de pouvoir non seulement suivre, mais également guider, l'implant lors de sa pose.It is therefore necessary for the practitioner to not only follow, but also guide, the implant during its installation.
L'art antérieur connaît déjà des dispositifs permettant le suivi de la pénétration d'un instrument dans une structure anatomique, en particulier une structure osseuse. En particulier, on connaît de la demande de brevet FR2835732, déposée par le présent demandeur, un dispositif permettant de suivre la pénétration d'un instrument de forage dans la vertèbre par la mesure des différences d'impédance électrique au fur et à mesure de la pénétration, de sorte que le praticien sait, à chaque instant, si l'extrémité de l'instrument sort du cortex osseux et pénètre dans une zone de tissus mous (moelle, nerfs, tissus). Dans ce cas, le praticien modifie la trajectoire de l'instrument de pénétration pour revenir dans le cortex osseux. Un tel dispositif permet ainsi de détecter la formation d'une brèche dans le cortex osseux au moment du forage de l'avant-trou. Pour ce faire, ledit dispositif de suivi objet de la demande comporte au moins un électrostimulateur apte à réaliser une stimulation neuromusculaire et pouvant être relié à au moins deux électrodes dont l'une au moins est située à une extrémité distale de l'instrument de forage, au moins un impédancemètre relié à au moins deux électrodes dont l'une au moins est située à une extrémité distale de l'instrument de forage, et au moins un dispositif de signalisation capable de produire un signal en cas de détection, par 1'impédancemètre d'une variation d'impédance.The prior art already knows devices for monitoring the penetration of an instrument into an anatomical structure, in particular a bone structure. In particular, it is known from the patent application FR2835732, filed by the present applicant, a device for monitoring the penetration of a drilling instrument in the vertebra by measuring the differences in electrical impedance as and when the penetration, so that the practitioner knows, at each moment, if the tip of the instrument comes out of the bone cortex and enters an area of soft tissue (marrow, nerves, tissue). In this case, the practitioner changes the trajectory of the penetration instrument to return to the bone cortex. Such a device thus makes it possible to detect the formation of a gap in the bone cortex at the time of drilling the pilot hole. To do this, said tracking device object of the application comprises at least one electrostimulator capable of performing neuromuscular stimulation and can be connected to at least two electrodes of which at least one is located at a distal end of the drill instrument at least one impedance meter connected to at least two electrodes, at least one of which is located at a distal end of the drilling instrument, and at least one signaling device capable of producing a signal in the event of detection, by 1 ' impedance meter of an impedance variation.
Cependant, un tel dispositif ne permet pas d'effectuer le suivi de la mise en place de l'implant dans l'avant-trou.However, such a device does not make it possible to track the placement of the implant in the pilot hole.
Le but de la présente invention est de proposer un équipement permettant le suivi et le guidage d'un implant lors de sa mise en place dans une structure osseuse, cette dernière étant forée soit directement par l'implant lors de sa pose, soit lors d'une opération préalable.The purpose of the present invention is to provide equipment for monitoring and guiding an implant during its implementation in a bone structure, the latter being drilled either directly by the implant during its installation, or during a preliminary operation.
A cet effet, l'invention concerne selon son acception la plus générale un implant destiné a être placé dans une structure anatomique, en particulier une structure osseuse.For this purpose, the invention relates, in its most general sense, to an implant intended to be placed in an anatomical structure, in particular a bone structure.
L'invention est remarquable en ce que ledit implant comprend au moins deux électrodes séparées l'une de l'autre par un isolant, lesdites électrodes affleurant la surface dudit implant de façon à permettre le suivi et le guidage dudit implant lors de sa mise en place dans la structure anatomique.The invention is remarkable in that said implant comprises at least two electrodes separated from one another by an insulator, said electrodes flush with the surface of said implant so as to allow tracking and guiding said implant during its establishment in the anatomical structure.
De préférence, lesdites électrodes sont disposées de telle sorte que : i) l'une des électrodes affleure au moins en partie la surface périphérique dudit implant, ii) l'autre électrode affleure ponctuellement la surface périphérique dudit implant.Preferably, said electrodes are arranged such that: i) one of the electrodes is at least partially flush with the peripheral surface of said implant, ii) the other electrode is punctually flush with the peripheral surface of said implant.
Avantageusement, lesdites électrodes sont disposées de telle sorte que : i) l'une des électrodes forme au moins en partie la surface périphérique dudit implant, ii) l'autre électrode, interne audit implant, affleure ponctuellement la surface distale dudit implant. L'implant ainsi configuré, il est possible de suivre la progression de sa pose dans la structure anatomique lorsqu'il est positionné à l'aide de l'instrument de pose adapté, lequel est décrit plus loin.Advantageously, said electrodes are arranged in such a way that: i) one of the electrodes forms at least part of the peripheral surface of said implant, ii) the other electrode, internal to said implant, is punctually flush with the distal surface of said implant. The implant thus configured, it is possible to follow the progress of its installation in the anatomical structure when it is positioned with the aid of the adapted laying instrument, which is described below.
De préférence, l'électrode externe est de forme sensiblement tubulaire.Preferably, the outer electrode is substantially tubular in shape.
De même, ladite électrode interne est avantageusement de forme sensiblement tubulaire.Likewise, said internal electrode is advantageously of substantially tubular shape.
Avantageusement, lesdites électrodes sont coaxiales ou excentriques. Dans un mode de réalisation préféré, la (ou les) électrode(s) est (sont) amovible(s).Advantageously, said electrodes are coaxial or eccentric. In a preferred embodiment, the (or) electrode (s) is (are) removable (s).
Avantageusement, ledit isolant est également amovible. Dans ce cas, son retrait sera effectué communément avec ladite électrode interne ou après le retrait de cette dernière.Advantageously, said insulator is also removable. In this case, its withdrawal will be performed commonly with said internal electrode or after removal of the latter.
La présente invention porte également sur l'implant non pourvu de la partie amovible précédemment décrite, à savoir l'électrode interne, et éventuellement l'isolant. Dans ce cas, l'implant, traversé par un canal, comporte au moins une électrode affleurant une partie au moins de la surface périphérique dudit implant, constituant en tout ou partie la paroi latérale dudit implant.The present invention also relates to the implant not provided with the removable part described above, namely the internal electrode, and possibly the insulator. In this case, the implant, crossed by a channel, comprises at at least one electrode flush with at least a portion of the peripheral surface of said implant, constituting all or part of the side wall of said implant.
De préférence, ledit implant est constitué par une électrode tubulaire.Preferably, said implant is constituted by a tubular electrode.
Avantageusement, ledit implant comporte un isolant de forme tubulaire.Advantageously, said implant comprises an insulator of tubular form.
Avantageusement, ledit canal traverse longitudinalement ledit implant. Avantageusement, le canal est un canal central.Advantageously, said channel passes longitudinally through said implant. Advantageously, the channel is a central channel.
La présente invention se rapporte également à un instrument de pose destiné à placer les implants précédemment décrits dans une structure anatomique, en particulier une structure anatomique osseuse. Pour ce faire, ledit instrument est relié à une source de tension alimentant au moins deux électrodes et à un moyen de mesure de l'impédance entre lesdites électrodes.The present invention also relates to a placement instrument for placing the implants previously described in an anatomical structure, in particular an anatomical bone structure. To do this, said instrument is connected to a voltage source supplying at least two electrodes and a means for measuring the impedance between said electrodes.
Dans le cas d'un implant non pourvu de la partie amovible telle que décrite précédemment, ledit instrument comporte une partie longitudinale interne. Cette partie longitudinale est destinée à se loger dans le canal de l'implant. Selon que l'implant soit pourvu ou non d'un isolant, ladite partie longitudinale sera constituée d'une électrode ou bien d'une électrode entourée d'un isolant.In the case of an implant not provided with the removable portion as described above, said instrument has an inner longitudinal portion. This longitudinal portion is intended to be housed in the canal of the implant. Depending on whether the implant is provided with an insulator or not, said longitudinal portion will consist of an electrode or an electrode surrounded by an insulator.
Avantageusement, la partie longitudinale dudit instrument est amovible. Ainsi, sans partie longitudinale, ledit instrument est adapté pour venir en prise avec un implant comprenant lui-même une électrode interne, laquelle est séparée de l'électrode externe par un isolant.Advantageously, the longitudinal portion of said instrument is removable. Thus, without longitudinal portion, said instrument is adapted to engage with an implant itself comprising an inner electrode, which is separated from the outer electrode by an insulator.
Avantageusement, ledit instrument comporte des moyens permettant le contact électrique avec la (ou les) électrode(s) lorsque ledit implant est en prise par ledit instrument. Le contact électrique pourra être réalisé de manière interne et/ou de manière externe. Ainsi, pour un contact interne, ledit instrument de pose comportera des éléments de contact électriques positionnés pour être en contact avec l'électrode interne de l'implant ; pour un contact externe, ledit instrument comportera des éléments de contact électriques positionnés pour être en contact avec l'électrode périphérique dudit implant.Advantageously, said instrument comprises means allowing electrical contact with the (or) electrode (s) when said implant is engaged by said instrument. The electrical contact may be made internally and / or externally. So, for a internal contact, said laying instrument will comprise electrical contact elements positioned to be in contact with the internal electrode of the implant; for an external contact, said instrument will comprise electrical contact elements positioned to be in contact with the peripheral electrode of said implant.
Avantageusement, ledit instrument comporte une cavité pour recevoir en partie ledit implant, ainsi que des moyens permettant de centrer ledit implant logé dans ledit instrument.Advantageously, said instrument comprises a cavity for partially receiving said implant, as well as means for centering said implant housed in said instrument.
Avantageusement, ledit instrument de pose comporte des moyens d'entraînement mécanique de l'implant.Advantageously, said laying instrument comprises means for mechanical drive of the implant.
L'implant et l'instrument ainsi configuré, il est alors possible de suivre la progression de l'implant lors de sa pose dans la structure osseuse par l'analyse d'un signal électrique établi au moyen desdites électrodes.The implant and the instrument thus configured, it is then possible to follow the progress of the implant during its placement in the bone structure by the analysis of an electrical signal established by means of said electrodes.
Lorsque l'extrémité distale du système, formé de l'instrument et de l'implant, est au contact d'une brèche formée dans la structure osseuse, l'impédance décroît brutalement. Ainsi informé, le patricien rectifie la trajectoire donnée à l'implant pour venir le repositionner dans la structure osseuse. Il est procédé ainsi jusqu'à parvenir à la mise en place finale dudit implant.When the distal end of the system, formed of the instrument and the implant, is in contact with a breach formed in the bone structure, the impedance decreases abruptly. Thus informed, the patrician rectifies the trajectory given to the implant to reposition it in the bone structure. This is done until the final placement of said implant.
On comprendra mieux l'invention à l'aide de la description, faite ci-après à titre purement explicatif, d'un premier mode de réalisation de l'invention, en référence aux figures annexées : la figure 1 illustre une vue en coupe d'un implant selon un mode de réalisation de l'invention ; la figure 2 illustre une vue en coupe de l'implant de la figure 1 après le retrait de la partie amovible dudit implant, ainsi qu'une vue en coupe de la partie amovible retirée de l'implant ; la figure 3 illustre une vue schématique d'un instrument de pose en prise avec l'implant de la figure 1 ; et la figure 4 illustre une vue en coupe d'un implant selon un second mode de réalisation de l'invention, ledit implant étant en prise avec un instrument de pose.The invention will be better understood from the following description, given purely for explanatory purposes, of a first embodiment of the invention, with reference to the appended figures: FIG. an implant according to one embodiment of the invention; Figure 2 illustrates a sectional view of the implant of Figure 1 after removal of the removable portion of said implant, and a sectional view of the removable portion removed from the implant; FIG. 3 illustrates a schematic view of a placement instrument in engagement with the implant of FIG. 1; and FIG. 4 illustrates a sectional view of an implant according to a second embodiment of the invention, said implant being engaged with a laying instrument.
La figure 1 illustre une vue en coupe d'un implantFigure 1 illustrates a sectional view of an implant
(1) selon un premier mode de réalisation de l'invention. Dans ce mode de réalisation, l'implant (1), du type vis pédiculaire, présente un corps (2) fileté cylindrique présentant une extrémité distale (13) en forme de pointe, l'autre extrémité étant pourvue d'une tête (3). Bien entendu, la présente invention ne se limite pas à cette configuration d'implant, celle-ci ayant été choisie dans le cas présent pour sa simplicité et donc faciliter la description de l'invention.(1) according to a first embodiment of the invention. In this embodiment, the implant (1), of the pedicle screw type, has a cylindrical threaded body (2) having a tip-shaped distal end (13), the other end being provided with a head (3). ). Of course, the present invention is not limited to this implant configuration, it has been chosen in this case for its simplicity and thus facilitate the description of the invention.
Le corps (2) dudit implant (1) comprend deux parties conductrices séparées par un isolant (6) . Plus particulièrement, chacune des parties conductrices est constituée par une électrode (4, 5) : une première électrode (4) formant la paroi latérale dudit implant (1) (« électrode externe ») de sorte que l'électrode externe (4) affleure la surface latérale (17) et une partie de la surface distale (18) du corps (2) dudit implant (1) ; une deuxième électrode (5) constituant une partie interne dudit implant (« électrode interne ») et affleurant ponctuellement la surface distale (18) du corpsThe body (2) of said implant (1) comprises two conductive parts separated by an insulator (6). More particularly, each of the conductive parts is constituted by an electrode (4, 5): a first electrode (4) forming the side wall of said implant (1) ("external electrode") so that the external electrode (4) is flush with the lateral surface (17) and a portion of the distal surface (18) of the body (2) of said implant (1); a second electrode (5) constituting an inner part of said implant ("internal electrode") and punctually flush with the distal surface (18) of the body
(2) dudit implant (1) . Avantageusement, l'électrode interne (5), en forme de tige de section circulaire, traverse longitudinalement ledit implant (1). Elle est entourée de l'isolant (6) lui- même entouré de l'électrode extérieure (4).(2) said implant (1). Advantageously, the inner electrode (5), in the form of a rod of circular section, passes longitudinally through said implant (1). It is surrounded by the insulator (6) itself surrounded by the outer electrode (4).
Selon un mode de réalisation préféré de l'invention, lesdites électrodes (4, 5) sont disposées de sorte à être coaxiales. Bien entendu, il s'agit d'un mode particulier de réalisation, étant entendu que le corps (2) dudit implant (1) peut être constitué par exemple de deux électrodes excentriques. Afin de faciliter le contact électrique avec un instrument destiné à la pose d'un tel implant (2) dans une structure osseuse, l'électrode interne (5) et l'isolant (6) se prolongent au travers de la tête (3) dudit implant (1).According to a preferred embodiment of the invention, said electrodes (4, 5) are arranged so as to be coaxial. Of course, this is a particular embodiment, it being understood that the body (2) of said implant (1) may consist for example of two eccentric electrodes. In order to facilitate electrical contact with an instrument for placing such an implant (2) in a bone structure, the inner electrode (5) and the insulator (6) extend through the head (3). said implant (1).
Selon un mode de réalisation particulièrement avantageux de l'invention, ledit implant (1) comporte une partie amovible (14). Ainsi, lorsque ladite partie amovible (14) est retirée, généralement une fois l'implant (1) positionné dans la structure osseuse, un canal est formé dans ledit implant (1), selon son axe longitudinal (cf. figure 2 ) .According to a particularly advantageous embodiment of the invention, said implant (1) comprises a removable part (14). Thus, when said removable portion (14) is removed, generally once the implant (1) positioned in the bone structure, a channel is formed in said implant (1) along its longitudinal axis (see Figure 2).
De préférence, la partie amovible (14) comprend à la fois l'électrode interne (5) et l'isolant (6). Cependant, il est évident qu'un homme du métier pourra prévoir que la partie amovible (14) de l'implant (1) soit constituée seulement de l'électrode interne (5), l'isolant (6) restant dans ledit implant (1) lors du retrait de ladite partie amovible (14) .Preferably, the removable portion (14) comprises both the inner electrode (5) and the insulator (6). However, it is obvious that a person skilled in the art can provide that the removable portion (14) of the implant (1) consists only of the internal electrode (5), the insulation (6) remaining in said implant ( 1) during removal of said removable portion (14).
Le retrait de certaines parties de l'implant, telles que l'électrode interne et l'isolant dans l'exemple décrit ci-dessus, permet d'éviter de laisser implanter dans le corps du patient plusieurs matériaux.The removal of certain parts of the implant, such as the internal electrode and the insulator in the example described above, makes it possible to avoid implanting several materials in the body of the patient.
En outre, seul les matériaux restant dans le corps du patient devant être' impérativement dits « implantables », les parties de l'implant retirées une fois ce dernier disposé dans la structure osseuse peuvent n'être constituées que de matériaux biocompatibles. Les matériaux biocompatibles étant moins onéreux que les matériaux implantables, un implant comprenant une partie amovible présentera ainsi l'avantage de présenter un coût de l'In addition, only the remaining materials in the patient's body to be 'imperatively called "implantable", the parts of the implant removed once it is disposed in the bone structure may only be made as biocompatible materials. Since biocompatible materials are less expensive than implantable materials, an implant comprising a removable part will thus have the advantage of presenting a cost of the
fabrication inférieur à un implant ne comprenant pas de partie amovible.manufacturing inferior to an implant that does not include a removable part.
La figure 3 illustre une vue simplifiée du contact électrique entre un instrument de pose (11) d'un implant dans une structure osseuse, et l'implant (1) précédemment décrit. Afin de simplifier la figure, il a été représenté un contact non effectif entre ledit implant (1) et ledit instrument (11). Le contact électrique entre l'instrument de pose (11) et l'implant (1) est réalisé par l'intermédiaire de pattes de connexion (12, 19) constituant ledit instrument de pose (11) : une patte de connexion (19) interne venant en contact avec l'électrode (5) interne dudit implant (1), et au moins une patte de connexion (12) externe venant au contact de l'électrode externe (4) dudit l'implant (1).FIG. 3 illustrates a simplified view of the electrical contact between an instrument (11) for placing an implant in a bone structure, and the implant (1) previously described. In order to simplify the figure, an ineffective contact has been shown between said implant (1) and said instrument (11). The electrical contact between the laying instrument (11) and the implant (1) is achieved by means of connecting lugs (12, 19) constituting said laying instrument (11): a connecting lug (19) internal contacting the internal electrode (5) of said implant (1), and at least one external connecting lug (12) coming into contact with the external electrode (4) of said implant (1).
En outre, s'agissant de suivre et de guider l'implant (1) lors de sa pose dans la structure osseuse, les pattes de connexion (12, 19) de l'instrument de pose (11) sont reliées à un moyen de mesure de l'impédance entre lesdites électrodes (4, 5) (impédancemètre 20).In addition, when it comes to following and guiding the implant (1) when it is placed in the bone structure, the connecting lugs (12, 19) of the laying instrument (11) are connected to a means of measuring the impedance between said electrodes (4, 5) (impedance meter 20).
Ledit impédancemètre (20) pourra avantageusement être relié à un dispositif d'alerte (non représenté) pouvant émettre un signal d'alerte visuel, sonore et/ou tactile lors d'une variation de l'impédance mesurée ou en cas de franchissement d'un seuil d'impédance.Said impedance meter (20) may advantageously be connected to an alert device (not shown) that can emit a visual, audible and / or tactile warning signal during a variation of the measured impedance or in case of crossing of an impedance threshold.
De même, ledit impédancemètre (20) pourra avantageusement être relié à un dispositif de visualisation (non représenté) permettant de visualiser les variations de l'impédance mesurée entre lesdites électrodes (4, 5) par 1'impédancemètre (20). Il pourra s'agir par exemple d'un écran de visualisation permettant le suivi, sous forme de courbes, de la variation de l'impédance au fur et à mesure de la pénétration de implant (1) dans la structure osseuse. l'Similarly, said impedance meter (20) may advantageously be connected to a display device (not shown) for displaying the variations of the impedance measured between said electrodes (4, 5) by the impedance meter (20). This may be for example a display screen for tracking, in the form of curves, the variation of impedance as implant penetration (1) into the bone structure. the
La figure 4 illustre une vue en coupe d'un implant (10) selon un autre mode de réalisation de l'invention et d'un instrument de pose (11) destiné à placer ledit implant (10) dans la structure osseuse.Figure 4 illustrates a sectional view of an implant (10) according to another embodiment of the invention and a delivery instrument (11) for placing said implant (10) in the bone structure.
Afin de faciliter la compréhension du principe de coopération de l'implant (10) avec ledit instrument (11), et en particulier de distinguer les éléments constituant respectivement ledit instrument de pose (11) et ledit implant (10), il a été représenté sur cette figure une coopération non effective entre ledit implant (10) et ledit instrument (11) .In order to facilitate the understanding of the principle of cooperation of the implant (10) with said instrument (11), and in particular to distinguish the elements respectively constituting said placing instrument (11) and said implant (10), it has been represented in this figure a non-effective cooperation between said implant (10) and said instrument (11).
Dans cet exemple de réalisation, ledit implant (10) est constitué d'un corps (2) fileté conducteur présentant une extrémité distale (13) en pointe.In this exemplary embodiment, said implant (10) consists of a conductive threaded body (2) having a pointed distal end (13).
Avantageusement, le corps (2) dudit implant (10), de forme tubulaire, est muni d'un canal (7) traversant d'une extrémité à autre le corps (2) dudit implant (1) .Advantageously, the body (2) of said implant (10), tubular in shape, is provided with a channel (7) passing from one end to another body (2) of said implant (1).
Avantageusement, le corps (2) dudit implant (10) est constitué par une électrode (4).Advantageously, the body (2) of said implant (10) is constituted by an electrode (4).
Ledit instrument de pose (11) destiné à venir en prise avec ledit implant (10) est constitué d'un corps creux (8) muni d'une partie longitudinale (9) centrale, laquelle est destinée à se loger dans le canal (7) dudit implant (10) lorsque celui-ci est en prise avec ledit instrument (11) .Said laying instrument (11) intended to engage with said implant (10) consists of a hollow body (8) provided with a central longitudinal portion (9), which is intended to be housed in the channel (7). ) of said implant (10) when it is engaged with said instrument (11).
Avantageusement, ladite partie longitudinale (9) centrale est constituée d'une électrode (15) entourée d'un isolant (16). Il est bien entendu évident que la partie longitudinale (9) pourra n'être constituée que de l'électrode (15), l'implant destiné à venir en prise avec ledit instrument de pose (11) comportant lui-même un isolant.Advantageously, said central longitudinal portion (9) consists of an electrode (15) surrounded by an insulator (16). It is of course obvious that the longitudinal portion (9) may consist only of the electrode (15), the implant intended to engage with said laying instrument (11) itself comprising an insulator.
Ainsi, lors de sa pose dans la structure osseuse, ledit implant (10) est fixé à l'extrémité dudit instrument (11), et la partie longitudinale (9) dudit instrument (11) logée dans le canal (7) dudit implant (10).Thus, during its placement in the bone structure, said implant (10) is attached to the end of said instrument (11), and the longitudinal portion (9) of said instrument (11) housed in the channel (7) of said implant (10).
Afin de suivre la progression de la pose de l'implant (10), une continuité électrique est établie. Avantageusement, le contact électrique est réalisé au moyen de pattes de connexion ( 12) venant au contact de l'électrode (4) constituant ledit implant (10).In order to follow the progression of the implantation of the implant (10), electrical continuity is established. Advantageously, the electrical contact is made by means of connection tabs (12) coming into contact with the electrode (4) constituting said implant (10).
Il a été présenté de l'instrument de pose (11) seulement la partie électrique permettant le suivi et le guidage d'un implant dans une structure osseuse. Il est bien entendu évident pour un homme du métier que ledit instrument de pose (11) pourra comporter des moyens d'entraînement mécanique manuel ou du type moteur électrique, permettant par exemple d'entraîner l'implant en rotation, en poussée, ou autre.Only the electrical part for the follow-up and guidance of an implant in a bone structure has been presented of the instrument (11). It is of course obvious to a person skilled in the art that said laying instrument (11) may comprise manual mechanical drive means or electric motor type, allowing for example to drive the implant in rotation, thrust, or other .
L'invention est décrite dans ce qui précède à titre d'exemple. Il est entendu que l'homme du métier est à même de réaliser différentes variantes de l'invention sans pour autant sortir du cadre du brevet. The invention is described in the foregoing by way of example. It is understood that the skilled person is able to realize different variants of the invention without departing from the scope of the patent.

Claims

l'REVENDICATIONS the CLAIMS
1. Implant (1) destiné à être placé dans une structure anatomique, en particulier une structure osseuse, caractérisé en ce qu'il comprend au moins deux électrodes (4, 5) séparées par un isolant (6), lesdites électrodes affleurant la surface dudit implant (1) de façon à permettre le suivi et le guidage dudit implant (1) lors de sa mise en place dans la structure anatomique.Implant (1) intended to be placed in an anatomical structure, in particular a bone structure, characterized in that it comprises at least two electrodes (4, 5) separated by an insulator (6), said electrodes flush with the surface said implant (1) so as to allow tracking and guiding said implant (1) during its establishment in the anatomical structure.
2. Implant (1) selon la revendication 1, caractérisé en ce que lesdites électrodes (4, 5) sont disposées de telle sorte que : i) l'une des électrodes (4) affleure au moins en partie la surface périphérique dudit implant (1), ii) l'autre électrode (5) affleure ponctuellement la surface périphérique dudit implant (1).2. Implant (1) according to claim 1, characterized in that said electrodes (4, 5) are arranged such that: i) one of the electrodes (4) is at least partially flush with the peripheral surface of said implant ( 1), ii) the other electrode (5) punctually outcrops the peripheral surface of said implant (1).
3. Implant (1) selon la revendication 1 ou la revendication 2, caractérisé en ce que lesdites électrodes3. Implant (1) according to claim 1 or claim 2, characterized in that said electrodes
(4, 5) sont disposées de telle sorte que : i) l'une des électrodes (4) forme au moins en partie la surface périphérique dudit implant (1) , ii) autre électrode (5) , interne audit implant (1) , affleure ponctuellement la surface distale dudit implant (1).(4, 5) are arranged such that: i) one of the electrodes (4) at least partly forms the peripheral surface of said implant (1), ii) another electrode (5), internal to said implant (1) , punctually outcrops the distal surface of said implant (1).
4. Implant (1) selon la revendication 3, caractérisé en ce que l'électrode (4) externe est de forme sensiblement tubulaire.4. Implant (1) according to claim 3, characterized in that the external electrode (4) is substantially tubular in shape.
5. Implant (1) selon la revendication 3 ou la revendication 4, caractérisé en ce que l'électrode (5) interne est de forme sensiblement tubulaire. l'5. Implant (1) according to claim 3 or claim 4, characterized in that the electrode (5) internal is substantially tubular. the
6. Implant (1) selon l'une quelconque des revendications précédentes, caractérisé en ce que lesdites électrodes (4, 5) sont coaxiales.6. Implant (1) according to any one of the preceding claims, characterized in that said electrodes (4, 5) are coaxial.
7. Implant (1) selon l'une quelconque des revendications 1 a 5, caractérisé en ce que lesdites électrodes (4, 5) sont excentriques.7. Implant (1) according to any one of claims 1 to 5, characterized in that said electrodes (4, 5) are eccentric.
8. Implant (1) selon une quelconque des revendications précédentes, caractérisé en ce que la (ou les) électrode(s) est (sont) amovible(s).8. Implant (1) according to any one of the preceding claims, characterized in that the (or) electrode (s) is (are) removable (s).
9. Implant (1) selon l'une quelconque des revendications précédentes, caractérisé en ce que ledit isolant (6) est amovible.9. Implant (1) according to any one of the preceding claims, characterized in that said insulator (6) is removable.
10. Implant (10) destiné a être placé dans une structure anatomique, en particulier une structure osseuse, caractérisé en ce qu'il comprend au moins une électrode (5) affleurant une partie au moins de la surface périphérique dudit implant (10) et en ce qu'il comporte un canal (7).Implant (10) intended to be placed in an anatomical structure, in particular a bone structure, characterized in that it comprises at least one electrode (5) flush with at least a portion of the peripheral surface of said implant (10) and in that it comprises a channel (7).
11. Implant (10) selon la revendication précédente, caractérisé en ce qu'il est constitué par une électrode (5) tubulaire.11. Implant (10) according to the preceding claim, characterized in that it consists of a tubular electrode (5).
12. Implant (10) selon la revendication 10 ou la revendication 11, caractérisé en ce qu'il comporte un isolant (6) de forme tubulaire.12. Implant (10) according to claim 10 or claim 11, characterized in that it comprises an insulator (6) of tubular form.
13. Implant (10) selon l'une quelconque des revendications 10 à 12, caractérisé en ce que le canal (7) traverse longitudinalement ledit implant (10). 13. Implant (10) according to any one of claims 10 to 12, characterized in that the channel (7) extends longitudinally through said implant (10).
14. Implant (10) selon l'une quelconque des revendications 10 à 13, caractérisé en ce que ledit canal (7) est central.14. Implant (10) according to any one of claims 10 to 13, characterized in that said channel (7) is central.
15. Instrument de pose (11) destiné à placer dans une structure anatomique, en particulier une structure anatomique osseuse, un implant (1) selon l'une quelconque des revendications 1 à 9 ou un implant (10) selon l'une quelconque des revendications 8 ou 10 à 14, ledit instrument (H) étant relié à une source de tension alimentant au moins deux électrodes et à un moyen de mesure de l'impédance entre lesdites électrodes, caractérisé en ce qu'il comporte une partie longitudinale (9) interne destinée à se loger dans le canal (7) dudit implant (10), ladite partie longitudinale (9) étant constituée par une électrode (15).15. A placement instrument (11) for placing in an anatomical structure, in particular an anatomical bone structure, an implant (1) according to any one of claims 1 to 9 or an implant (10) according to any one of claims 8 or 10 to 14, said instrument (H) being connected to a voltage source supplying at least two electrodes and to a means for measuring the impedance between said electrodes, characterized in that it comprises a longitudinal part (9 ) intended to be housed in the channel (7) of said implant (10), said longitudinal portion (9) being constituted by an electrode (15).
16. Instrument (11) selon la revendication précédente, caractérisé en ce que ladite électrode (15) est entourée d'un isolant (16).16. Instrument (11) according to the preceding claim, characterized in that said electrode (15) is surrounded by an insulator (16).
17. Instrument (11) selon la revendication 15 ou la revendication 16, caractérisé en ce que la partie longitudinale (9) dudit instrument (11) est amovible.17. Instrument (11) according to claim 15 or claim 16, characterized in that the longitudinal portion (9) of said instrument (11) is removable.
18. Instrument (H) selon l'une quelconque des revendications 15 à 17, caractérisé en ce qu'il comporte des moyens permettant le contact électrique avec la (ou les) électrode(s) (4, 5, 15) lorsque ledit implant (1, 10) est en prise par ledit instrument (11).18. Instrument (H) according to any one of claims 15 to 17, characterized in that it comprises means allowing electrical contact with the (or) electrode (s) (4, 5, 15) when said implant (1, 10) is engaged by said instrument (11).
19. Instrument (H) selon l'une quelconque des revendications 15 à 18, caractérisé en ce qu'il comporte en outre une cavité pour recevoir en partie ledit implant (1, 10), ainsi que des moyens permettant de centrer ledit implant (1, 10) logé dans ledit instrument (H). 19. Instrument (H) according to any one of claims 15 to 18, characterized in that it further comprises a cavity for partially receiving said implant (1, 10), as well as means for centering said implant ( 1, 10) housed in said instrument (H).
20. Instrument (11) selon l'une quelconque des revendications 15 à 19, caractérisé en ce qu'il comporte des moyens d'entraînement mécanique de l'implant (1, 10). 20. Instrument (11) according to any one of claims 15 to 19, characterized in that it comprises mechanical drive means of the implant (1, 10).
PCT/FR2005/002143 2004-08-25 2005-08-25 Implant comprising one or more electrodes and corresponding insertion instrument WO2006024801A2 (en)

Priority Applications (10)

Application Number Priority Date Filing Date Title
EP05798589.7A EP1781198B1 (en) 2004-08-25 2005-08-25 Implant comprising one or more electrodes and corresponding insertion instrument
BRPI0515208A BRPI0515208B8 (en) 2004-08-25 2005-08-25 implant and implant placement instrument
ES05798589.7T ES2534992T3 (en) 2004-08-25 2005-08-25 Implant comprising one or more electrodes and associated installation instrument
CA2578346A CA2578346C (en) 2004-08-25 2005-08-25 Implant comprising one or more electrodes and corresponding insertion instrument
CN2005800364469A CN101048111B (en) 2004-08-25 2005-08-25 Implant comprising one or more electrodes
US11/660,418 US8486119B2 (en) 2004-08-25 2005-08-25 Implant comprising one or more electrodes and corresponding insertion instrument
AU2005279023A AU2005279023B2 (en) 2004-08-25 2005-08-25 Implant comprising one or more electrodes and corresponding insertion instrument
JP2007528926A JP2008510549A (en) 2004-08-25 2005-08-25 Implants including one or more electrodes and associated insertion devices
IL181534A IL181534A (en) 2004-08-25 2007-02-25 Implant comprising one or more electrodes and corresponding insertion instrument
KR1020077006162A KR101473374B1 (en) 2004-08-25 2007-03-16 System made up of implant comprising one or more electrodes and corresponding insertion instrument

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FR0409092 2004-08-25
FR0409092A FR2874497B1 (en) 2004-08-25 2004-08-25 IMPLANT COMPRISING ONE OR MORE ELECTRODES AND ASSOCIATED INSTALLATION INSTRUMENT

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WO2006024801A3 WO2006024801A3 (en) 2006-06-01

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EP (1) EP1781198B1 (en)
JP (1) JP2008510549A (en)
KR (1) KR101473374B1 (en)
CN (2) CN101897617B (en)
AU (1) AU2005279023B2 (en)
BR (1) BRPI0515208B8 (en)
CA (1) CA2578346C (en)
ES (1) ES2534992T3 (en)
FR (1) FR2874497B1 (en)
IL (1) IL181534A (en)
RU (1) RU2365353C2 (en)
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